How Big is the Risk in Girls’ Soccer?

WHY YOU SHOULD CARE

If you’re one of the millions of soccer parents in America, you should know what risk your kid runs for head injury, and when to keep her on the sidelines.

March 24, 2014

Being short is not necessarily a disadvantage in the game of soccer, unless, that is, you’re going up for a header. When you’re trying to make contact between your head and a soccer ball soaring through the air (while simultaneously trying to muscle off a competing player aiming to do the same thing), well, it helps to be tall. But that never stopped me in my playing days, despite being an undersized 5 foot 4 (if you round up). And I paid for it with innumerable elbows to the head, nose and neck.

My worst header-related injury, however, came when I clocked domes with a significantly taller girl in a scrimmage my senior year of high school. Both of us had left the ground trying to win a ball that had been punted some 40 yards down field, in a high, swooping arc. The crunching impact of skull hitting skull was enough to split my scalp open, requiring four stitches to close up. Coming out of the doctor’s office, I spotted the same player I’d knocked heads with, sitting in the waiting room. I found out later she was diagnosed with a minor concussion.

Youth soccer is the cause of some of the highest numbers of head injuries of any sport.

At the time, I was just relieved that I’d avoided having a chunk of my hair cut out when they stitched me up—which would have severely messed up my ’do just weeks before homecoming. I probably should have been more concerned with the state of my brain, and the fact that I was lucky enough to avoid any concussion-like symptoms.

Source Corbis

Because although I was completely unaware of this when I was in high school almost 20 years ago, studies are now finding youth soccer is the cause of some of the highest numbers of head injuries of any sport. And a growing body of research suggests that not only are girl players reporting higher rates of concussions than boys in soccer , but they’re at risk of more severe health consequences if they do have this kind of head injury. And, a new report out of Seattle shows, middle school-age girls are not stopping play even when they display concussion symptoms, further upping the risk of recurring problems. With all the attention being paid to the long-term repercussions of head injuries in pro sports like football in recent years, health professionals and parents are now taking a second look at one of American kids’ most popular sports.

• Sports are the second leading cause of concussions among people between 15 to 24 years old (after car crashes)

• Concussions make up 13 percent of overall high school sports injuries

So we ask: should girls’ soccer—or perhaps youth soccer in general—ban headers all together?

Since 1990, the number of kids registering to play youth soccer in the U.S. has nearly doubled to 3 million, according to statistics from U.S. Youth Soccer . And girls make up 48 percent of those players. Anecdotal evidence suggests that soccer—like other youth sports—has also gotten more physical, as the competition has grown more intense and kids grow bigger, stronger and faster. A rise in the number of concussions, then, is not surprising.

What is surprising is where female players rank when it comes to head injury risks.

In a 2012 study, researchers in collaboration with the Research Institute at Nationwide Children’s Hospital in Columbus, Ohio, followed athletes in 20 high schools sports over two years to evaluate head injury rates. They found that of the nearly 2,000 concussions suffered, high school girls reported 159 concussions (second only to boys’ high school football, which was far ahead of any other sport with more than 900). The study also found the concussion rate in girls’ soccer was almost twice that of the boys’ game. For both genders, heading the ball was to blame.

We’re talking about kids’ heads here.

Even more worrying: a January report from Washington researchers found even when early-teen girls displayed symptoms of a concussion, nearly 60 percent continued to play, raising the risks of long-lasting health problems. This was despite the fact that in 2009, Washington became the first state in the nation to pass a youth sports concussion safety law, requiring players suspected of having a concussion to get written clearance from a health professional before being allowed to play again.

Now, it’s worth noting that concussions are rare even in youth soccer—occurring in well less than 1 percent of all high school games and practices the 2012 study measured.

Still, we’re talking about kids’ heads here. Knee surgery isn’t fun but it’s far less debilitating than long-term problems with cognition or emotion. Would you really want to run that risk—even a small one—if it’s your kid on the field? Is winning a header in a soccer game really worth it?

Some parents and soccer leagues are saying no. In Northern Virginia, a youth soccer hotbed, longtime club coach Jerry Ellison says some of the Arlington boys he coaches are not allowed to head the ball in their middle school league. He’s seen parents preemptively send their daughters to practices with cushioned headgear to protect against knocks to the skull.

But he’s not sure banning headers for certain age groups, boys or girls, is really the answer to preventing head injuries. Ellison suggests eliminating headers wouldn’t stop kids from jumping to win balls in the air other ways. “I just don’t know that it would have the kind of effect on head injuries that were being intended.”

And as a former soccer player, I tend to agree.

The bigger problem is that awareness of head injuries doesn’t seem to be trickling down to the decision-making process that occurs in the moment when kids do get injuries, or in a recognition that girls could be particularly at risk of long-term problems. Plus, kids don’t always recognize the seriousness of their symptoms, which means they don’t report them, says Dr. John O’Kane, a professor at University of Washington’s medical school and the lead author of the Washington study.

Before banning headers, what girls’ soccer sounds like it really needs is more rigorous monitoring and playing restrictions to protect those millions of little heads.